Predictive value of GAS,MTL,PGs and Ghrelin levels before resection of gastric polyps on postoperative recurrence of gastric polyps

Yang Linghe; Zhang Mengxia; Qiao Kun; Gao Feng

doi:10.3969/j.issn.1671-6450.2024.08.007

Abstract：Objective To explore the predictive value of preoperative gastrin(GAS),motilin(MTL),pepsinogen(PGs)and Ghrelin levels in postoperative recurrence of gastric polyps.Methods One hundred and twenty-eight patients who underwent gastric polypectomy at People's Hospital of Xinjiang Uygur Autonomous Region between May 2019 and December 2021 were included in this study.All patients were followed up for a duration of 2 years.Based on the recurrence of gastric polyps,they were categorized into two groups:non-recurrent group(n=86)and recurrent group(n=42).The general clinical information,as well as surgical and pathological data,were collected and compared between the two groups.Additionally,the levels of gastrointestinal hormones such as GAS,MTL,PGs,and Ghrelin were measured and compared pri-or to the operation.Spearman correlation analysis,univariate,and multivariate Logistic regression analysis were conducted to identify the risk factors for postoperative recurrence of gastric polyps.Furthermore,the independent and combined pre-dictive value for gastric polyp recurrence was evaluated using a receiver operating characteristic(ROC)curve.Results The recurrent group showed significantly longer duration for endoscopic operations,a higher prevalence of multiple gastric pol-yps,and a higher proportion of patients with a maximum gastric polyp diameter＞2cm compared to the non-recurrent group(Z/x2/P=3.453/0.001,5.965/0.015,7.342/0.007).Additionally,the average preoperative serum levels of GAS,MTL,PGⅠ,PG Ⅱ,and Ghrelin were significantly higher in the recurrent group compared to the non-recurrent group(t/P=7.736/＜0.001,5.984/＜0.001,6.326/＜0.001,6.420//＜0.001,6326/＜0.001).Spearman correlation analysis showed that endoscopic op-eration time,multiple gastric polyps,maximum diameter of gastric polyps＞2 cm,serum GAS,MTL,PG Ⅰ,PGⅡ and Ghrelin were positively correlated with postoperative recurrence of gastric polyps(r/P=0306/＜0.001,0216/0.014,0239/0.006,0.563/＜0.001,0.453/＜0.001,0.486/＜0.001,0.484/＜0.001,0.458/＜0.001).Multivariate Logistic regression analysis,indicated that ele-vated serum levels of GAS,MTL,PGⅠ,PGⅡ,and Ghrelin were significant risk factors for recurrence in postoperative pa-tients with gastric polyps[OR(95％CI)=1.394(1.086-1.789),1.098(1.031-1.169),1.081(1.026-1.139),1.793(1264-2.542),1.059(1.007-1.114)].Furthermore,the predictive efficacy of serum levels of GAS,MTL,PGⅠ,PGⅡ,and Ghrelin in deter-mining disease recurrence after gastric polypectomy was noteworthy,with improved accuracy when combined together(Z=3.014/＜0.001,3.666/＜0.001,3.354/＜0.001,3.355/＜0.001,3.462/＜0.001).Conclusion The presence of gastric polyps in postoperative patients has been found to have a significant correlation with the levels of serum GAS,MTL,PGs,and Ghre-lin.In order to predict and prevent the recurrence of gastric polyps,it is clinically important to closely monitor the levels of gastrointestinal hormones in these patients.This timely intervention can greatly improve the prognosis and overall outcome.